There is an enduring need for an inexpensive and effective device and method for the relief of head, neck, facial, joint and tooth pain caused by the parafunctional movement of the jaws and teeth. The design and function of the present invention are different than the prior art in form, function, cost and retail availability.
A variety of stressors affect the neuromuscular system of the head and neck. Among them are abnormal dental contacts, muscle tension and spasms, psychological stress factors, genetic predispositions, physical trauma and inflammation. In the presence of stressors the jaw muscles contract irregularly or parafunctionally causing the hitting together of the teeth. This interarch dental contact triggers headaches, both radiating and migraine, muscular tension, inflammation, structural damage to ligaments and tendons, fractures and excessive wear of the teeth, arthritic changes to the temporomandibular joint and periodontal disease. The pain generated radiates to other muscles, namely muscles for chewing and posture within the head, neck and back. The cycle of pain and structural damage thus created becomes the motivation for the efforts to design a device to minimize or eliminate these symptoms.
The prior art generally employs various platforms and protuberances to separate the teeth beyond the freeway space and beyond the physiologic rest position, making them less effective in eliminating pathologic muscle engrams and less likely to disrupt the cycle of pain and structural damage. The wider the mandible is forced to open by these platforms and protuberances, the more neuromuscular feedback is created and the less likely these devices are to disrupt the existing pathologic muscle engrams. In addition, these devices often require fittings by dental professionals and are therefore inconvenient and expensive for mass usage. By contrast, one embodiment of the device of the present invention is installed by the user, and would be relatively inexpensive at the retail level. The device of the present invention functions within the freeway space to effectively deprogram the neuromuscular system of the head and neck by preventing contact of the upper and lower posterior teeth.
The prior art focused on the use of medications for pain relief or the fabrication of devices whose goal was to separate the teeth and reposition the jaws. Typical of these devices are U.S. Pat. No. 4,671,766 to Norton; U.S. Pat. No. 4,519,386 to Sullivan; U.S. Pat. No. 5,277,203 to Hays; U.S. Pat. No. 6,581,603 to Schames; and U.S. Pats. Nos. 5,085,584; 5,513,656; 5,795,150; and 6,666,212 to Boyd.
These treatments are often extremely expensive and/or ineffective. A more effective device and treatment are needed, as well as a device that is readily and easily obtained at a reasonable cost and is simple to install and use.
The present invention takes into account the need to eliminate the forced positioning of a person's mandible to or beyond the physiologic rest position. The freeway space, or interocclusal space, is defined as the distance between the physiologic rest position and the first point of contact of the upper and lower teeth when the jaws are brought together. The freeway space has been observed to usually be between 2 and 7 millimeters (mm) with an approximate average for adults of 3.5 mm. The physiologic rest position is the position assumed by the mandible when the head is in an upright position, the neuromuscular system is in equilibrium in minimum tonic contraction and the condyles are at rest. The more an intra-oral device forces the mandible to open beyond the physiologic rest position, the more active neuromuscular feedback mechanisms become. This feedback triggers pathologic engrams. An engram is a memorized pattern of muscle activity. Pathologic engrams may also be remediated or eliminated by occlusal adjustment, occlusal reconstruction, retraining or through the use of medication. Thus the cycle of pain and structural damage can be interrupted temporarily or permanently. Prior art devices and methods cause the mandible to be forced open beyond the limit of the freeway space, making them less likely to interrupt the cycle of pain and structural damage. What is needed, then, are a device and method that functions only within the freeway space, while effecting disclusion of the posterior teeth and maintaining clearance within the freeway space, thereby eliminating or significantly reducing pathologic engrams.
The prior art, directed to the reduction of headaches and temporomandibular joint (TMJ) pain, functions outside of a user's freeway space. In one of its aspects, the present invention provides a device that may be installed by a dental professional to fit a user. In another aspect, the present invention allows a user to fit the device to function only within the freeway space.
Posterior disclusion with an anterior bite device is based on the concept that the temporomandibular joint will seat itself physiologically if the proprioceptive interferences of the teeth and periodontal ligaments are removed. Thus the neuromuscular system will function freely within the freeway space. Once a user's pathologic muscle engrams have been eliminated, the temporomandibular joint becomes stable. In order to decrease the likelihood of the cycle of pain and structural damage returning, an occlusal adjustment with or without occlusal reconstruction may be necessary.